• Title/Summary/Keyword: Abdominal symptoms

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Studies on Intestinal Trematodes in Korea XI. Two Cases of Human Infection by Heterphyes heterphyes nocens (한국의 간흡충에 관한 연구 XI. Heterophyes heterphyes nocens의 인체감염 2례)

  • 채종일;서병설이순형
    • Parasites, Hosts and Diseases
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    • v.22 no.1
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    • pp.37-42
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    • 1984
  • Two human cases of Heterophyes heterophyes nocens infection were proved by identifying adult worms after treatment with bithionol or praziquantel in 1983 in Korea. They are 37 (Case 1) and 24-year old (Case 2) males whose resi¬dence or native village is a southern coastal area in Kohiing-gun, Chollanam-do. The Case 1 had the gastrointestinal symptoms such as epigastric pain and indigestion, and the Case 2 heart problems such as arrhythmia and ventricular premature beat in EKG and digestive symptoms such as diarrhea and abdominal pain. After the treatments, 35 and 67 specimens of H. hetero¬phyes nocens respectively were collected from the diarrheal stools through stereomicroscopy. The Case 1 was concommitantly infected with Clonorchis sinensis and the Case 2 with 3 other kinds of heterophyid flukes and with Diphyllo¬bothrium latum. The cases said to have eaten raw brackish water fish such as mullets (Mugil cephalus), perches (Lateolabrax japonicus) and gobies (Acanthogobius flavimanus) which are the intermediate hosts of H. heterophyes nocens in Korea.

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The clinical effects of rabeprazole sodium($Pariet^{\circledR}$) in the treatment of Layngopharyngeal Reflux (인후두역류질환 (Laryngopharyngeal Reflux Disease, LPRD)에서 Rabeprazole Sodium($Pariet^{\circledR}$)의 임상효과)

  • 최홍식;최현승;김한수
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.60-66
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    • 2003
  • Although there is a wide range of diseases caused by gastric acid reflux and the number of cases is on the rise, it is difficult for the laryngologist to make the correct diagnosis. The treatment for laryngopharyngeal reflux can be grouped into 3 categories - changes in lifestyle, medication, and surgery. The medication used to treat laryngopharyngeal reflux are prokinetic agents and acid supressive agents such as antacids, H2 blockers, and PPIs(Proton pump inhibitor). Rabeprazole sodium($Pariet^{\circledR}$) is a newly developed agent belonging to the PPI group, but in contrast with the existing drugs such as omeprazole, lansoprazole, pantoprazole, has a low dependency on CYP2C19 during the metabolic cycle. Thus, it is known to have a quick but fixed antiacid effect and less individual differences. We analyzed 2166 patients from 32 hospitals who were prescribed $Pariet^{\circledR}$ from May, 2001 to April, 2002. The patients were divided into 4 groups according to the duration of treatment - Group 1: 1-14 days, Group 2: 15-28 days, group 3: 29-56 days, Group 4: more than 56 days. The cases were then analyzed for improvement of 8 symptoms(heart bum, regurgitation, chronic cough, hoarseness, globus sensation, chronic throat clearing, sore throat, and dysphagia), improvement on laryngoscope, usefulness to the doctor, and complication development. Of the total of 2116 patients, 1627(75.1%) cases showed at least 50% improvement of symptoms and the amount of improvement increased according to the duration of medical treatment. Most of the patients showed objective improvement on the laryngoscope, with 32.9% showing significant improvement and 38.7% showing moderate improvement. 37.6% of the doctors questioned replied that $Pariet^{\circledR}$ was very useful and 50.3% said it was useful, showing that most were satisfied with the treatment results. The complications known to develop after taking PPI are headache, nausea, diarrhea, abdominal pain, constipation, dizziness, fatigue, and of these, only a small percentage of the patients complained of mild headache. $Pariet^{\circledR}$ has shown to be a relatively safe and effective drug for the treatment of laryngopharyngeal reflux.

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A Case of Delayed Administration of Naloxone for Morphine Intoxicated Patient (Morphine 과량복용 후 중독증상을 보인 환자의 지연된 Naloxone 치료 1례)

  • Kim, Gun-Bea;Park, Won-Nyung;Gu, Hong-Du
    • Journal of The Korean Society of Clinical Toxicology
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    • v.10 no.1
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    • pp.33-36
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    • 2012
  • Opioids are the one of the most commonly used drugs to control cancer pain all over the world. But, we should not overlook the potential risk of opioid intoxication because they have well-known detrimental side effects. The opioid intoxication can be diagnosed thorough various clinical manifestations. The altered mental status, respiratory depression, and miosis is very representative clinical features although these symptoms don't always appear together. Unfortunately the opioid-toxidrome can be varied. A 42 years old man came to our emergency room after taking about 900 mg morphine sulfate per oral. He was nearly alert and his respiration was normal. Even though his symptoms didn't deteriorated clinically, serial arterial blood gas analysis showed increase in PaCO2. So we decided to use intravenous naloxone. Soon, he was fully awaked and his pupils size was increased. After a continuous infusion of intravenous naloxone for 2 hours, PaCO2 decreased to normal range and his pupil size also returned to normal after 12 hours. Though the levels of serum amylase and lipase increased slightly, his pancreas was normal according to the abdominal computed tomography. He had nausea, vomit, and whole body itching after naloxone continuous infusion, but conservatively treated. We stopped the continuos infusion after 1 day because his laboratory results and physical examinations showed normal. As this case shows, it is very important to prescribe naloxone initially. If you suspect opioid intoxication, we recommend the initial use of naloxone even though a patient has atypical clinical features. In addition, we suggest intranasal administration of naloxone as safe and effective alternative and it's necessary to consider nalmefene that has a longer duration for opioid intoxication.

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Primary Idiopathic Myelofibrosis: Clinico-Epidemiological Profile and Risk Stratification in Pakistani Patients

  • Sultan, Sadia;Irfan, Syed Mohammed
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8629-8631
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    • 2016
  • Background: Primary idiopathic myelofibrosis (PMF) is a clonal Philadelphia chromosome-negative myeloproliferative neoplasm characterized by extramedullary hematopoiesis and marrow fibrosis. It is an uncommon hematopoietic malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-epidemiological profile along with risk stratification in Pakistani patients. Materials and Methods: In this retrospective cross sectional study, 20 patients with idiopathic myelofibrosis were enrolled from January 2011 to December 2014. Data were analyzed with SPSS version 22. Results: The mean age was $57.9{\pm}16.5years$ with 70% of patients aged above 50. The male to female ratio was 3:1. Overall only 10% of patients were asymptomatic and the remainder presented with constitutional symptoms. In symptomatic patients, major complaints were weakness (80%), weight loss (75%), abdominal discomfort (60%), night sweats (13%), pruritus (5%) and cardiovascular accidents (5%). Physical examination revealed splenomegaly as a predominant finding detected in 17 patients (85%) with the mean splenic span of $22.2{\pm}2.04cm$. The mean hemoglobin was $9.16{\pm}2.52g/dl$ with the mean MCV of $88.2{\pm}19.7fl$. The total leukocyte count of $17.6{\pm}19.2{\times}10^9/l$ and platelets count were $346.5{\pm}321.9{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $731.0{\pm}154.1$, $0.82{\pm}0.22$ and $4.76{\pm}1.33$ respectively. According to risk stratification, 35% were in high risk, 40% in intermediate risk and 25% in low risk groups. Conclusions: The majority of PMF patients were male and presented with constitutional symptoms in our setting. Risk stratification revealed predominance of advanced disease in our series.

A study on Sik-jeok in Dong-ui-bo-gam (동의보감(東醫寶鑑)을 통한 식적(食積)에 대한 고찰)

  • Roh, Ju-hee;Lee, Jae-heung;Jang, Myeong-jun;Bae, Jae-ryong
    • Journal of Korean Medical Ki-Gong Academy
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    • v.11 no.1
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    • pp.173-197
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    • 2009
  • 1. The concept about Jeok-chwiui(積聚) has been around since before "Hwangje-Naegyeong". Since "Hwangje-Naegyeong(黃帝內經)", Sik-jeok(食積) was made mention of specifically. In "Yu-gyeong(類經)", it is said that Sik-jeok is a combination of our body fluid and blood by bad eating and sleeping habits. 2. In the narrow sense Sik-jeok is indigestion and broadly it is inappropriately stagnant fluids in our body. 3. If studying on Sik-jeok in Dong-ui-bo-gam 1) It is located on the right side, in the epigastric region and between the skin and fascia. 2) The cause of Sik-jeok is indigestion, inappropriate temperature and weak stomach. 3) Symptoms of Sik-jeok are very diverse such as sick ascension, nausea, abdominal pain, headache, fever, etc. The right pulse is big and stressful. 4) Various symptoms related to digestive, respiratory, circulatory and reproductive system are represented by Sik-jeok. - Contemporarily women uterine or ovarian disease and back pain are mostly caused by Sik-jeok 5) Pediatric disease are mostly caused by Sik-jeok. 6) Treatment of Sik-jeok is light eating and if it is serious, you have to induce vomiting or diarrhea. Commonly used drugs are digestive medicine and invigorative medicine 7) To prevent Sik-jeok, you should forbid to eat until you are satisfied and wear warm clothes and continue to do spleen and genital do-in-beop.

The clinical effect of Gagamjeonsibaekchul-san on child diarrhea (소아설사(小兒泄瀉)에 대한 가감전씨백출산(加減錢氏白朮散)의 임상효능(臨床效能)에 관한 연구(硏究))

  • Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.1-9
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    • 2004
  • Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchul-san on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchul-san, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san, san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaekchul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

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The clinical effect of Gagamjeonsibaekchul-san on child diarrhea (소아설사(小兒泄瀉)에 대한 가감전씨백출산(加減錢氏白朮散)의 임상효능(臨床效能)에 관한 연구(硏究))

  • Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.18 no.2
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    • pp.11-11
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    • 2004
  • Objectives: The objective of this study is to assess the clinical effect of Gagamjeonsibaekchulsan on child diarrhea. Methods: This clinical study was carried out with 42 cases(31male, 11female) of children aged 0 to 14 years old who visited the Department of Pediatrics, Dongguk University Bundang Oriental Hospital and were diagnosed as the diarrhea. Assessments were made with reference to sex, age, the duration of symptoms and physical history. To assess the impact of Gagamjeonsibaekchulsan, the complicated signs, the duration of treatment, the correlation between the use of Gagamjeonsibaekchul- san and the duration of symptom were examined before and after the treatment. Results: There were 31 males and 11 females in the incidence by sex. It showed that males were more than females. The most numerous age group was 0-2(19) followed by 3-7 (11) and 9-12 (12). According to the duration of symptom, 12 children have symptom for 0-7 days, 10 for 8-14 days, 11 for 15-20 days, 4 for 22-28 days and 5 over 28 days. With regard to the physical history of the sample, 5 children had atopic dermatitis, 3 children had enteritis, 3 children had rhinitis, 2 children had tonsillitis, 1 child had otitis media, 1 child had asthma and 1 child had pneumonia. The children also had the complicated signs: 22 children had anorexia, 17 children had abdominal pain, 13 children had vomiting and 8 children had nausea in digestive organ. In addition 11 children had dizziness, 7 children had general weakness, 1 child had enuresis and 1 child had sweat in general symptoms. For the duration of the treatment, 14 children were treated for 7 days, 13 for 8-10 days, 8 for 11-14 days, 3 for 15-21 days, 2 for 22-28 days and 2 for 29-40 days. No distinct relationship between the use of Gagamjeonsibaekchul-san and the duration of the symptom was found. Conclusion: Gagamjeonsibaeichul-san is effective in the treatment of intestine mucous membrane and improves the function of digestive system. It is also an effective short-term treatment for child diarrhea.

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Treatment of Severe Small Bowel Involvement in Henoch-Schönlein Purpura: Two Cases Report (심한 소장침범을 보인 Henoch-Schönlein Purpura의 치료 2례)

  • Kim, Hyung Tae;Moon, Jin Soo;Jang, Hyun Oh;Jo, Heui Seung;Lee, Jong Guk;Kim, Ki Hong;Seo, Jung Wook;Kim, Min Kyung
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.78-82
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    • 2004
  • Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a vasculitis of the small vessels in skin, joints, gastrointestinal (GI) tract and kidney. GI symptoms occur in up to 85% of patients and may lead to severe problems such as intussusception, obstruction, and perforation. GI symptoms may not be easily controlled, showing refractoriness to the conventional corticosteroid therapy. Although GI involvements of HSP are acute, and self-limited in most instances, they may cause fatal results in some unusual cases. In such conditions all the possible therapeutic modalities should be considered. We report two cases of severe small bowel involvement of HSP. One case presented with severe abdominal pain showing refractoriness to corticosteroid, but improved with IV immunoglobulin therapy. In the second case, HSP with transmural infarction in the small bowel could be cured with surgical intervention.

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Epidemiologic Investigation on Sporadic Occurrence of Shigellosis in a Subcounty of Cheongwon County in Chungbuk Province in 2003 (청원군 일개 면에서 산발적으로 신고한 세균성이질 집단 발병 역학조사)

  • Lee, Yong-Jae;Hwang, Ue-Kyoung;Kim, Jong-Suk;Kim, Jun-Young;Lee, Bok-Kwon;Koo, Ja-Seol;Kang, Jong-Won
    • Journal of Preventive Medicine and Public Health
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    • v.38 no.2
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    • pp.182-188
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    • 2005
  • Objectives: This study was undertaken to investigate the source of infection and mode of transmission of shigellosis, which occurred sporadically among residents and students in a subcounty of Cheongwon county, Chungbuk province, Korea, from June 4 to July 3 2003. Methods: 692 subjects completed a questionnaire and provided a swab for microbiological examinations,and 7 environmental specimens were examined for bacterial organisms. PFGE (pulsed-field gel electrophoresis) and fingerprinting were performed to find the genetic relationship among the temporally associated sporadic isolates. Results: A total of 29 patients had symptoms consistent with the case definition, with 13 confirmed and 16 suspected cases. The frequency of diarrhea was 6 times or more a day (80.8%), with a duration of 1 to 4 days (88.5%) in most cases. The most common symptoms accompanying the diarrhea were fever (80.9%) followed by abdominal pain (76.9%), headache (65.4%), chill (61.5%), vomiting (46.2%) and tenesmus (15.4%). The epidemic curve was characteristic of a person-to-person transmission. The PFGE and fingerprinting demonstrated identical or similar DNA patterns among the 3 Shigella sonnei isolates (A51, A53 and A61 types) found in this outbreak. Conclusion: A genetically identical strain of S. sonnei was estimated to be the cause of this outbreak, and the mode of transmission was most likely person-to-person.

Choledochocele containing a stone mistaken as a distal common bile duct stone (원위부 총담관 결석으로 오인된 결석을 동반한 총담관류 치료)

  • Kwak, Tae Young;Park, Chang Hwan;Eom, Seok Hyeon;Hwang, Hong Suk;Chung, Duk Won;Seo, Ji Young;Kim, Yeong Sung;Kwak, Dong Hyup
    • Journal of Yeungnam Medical Science
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    • v.32 no.1
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    • pp.60-64
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    • 2015
  • A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.